Core Software
Majesco Claims for L&AH
Maximize Your Claims Management Potential
Claims for L&AH offers flexible, simplified, and straight-through processing (STP) first automation capabilities, allowing insurers to streamline the entire claims lifecycle for a wide range of insurance products. Experience advanced claims management features, including end-to-end processing, appeals management, and a comprehensive 360-degree dashboard. Our platform helps deliver exceptional customer experiences through digitally-enabled claims handling and empower claims adjusters to meet the evolving expectations of policyholders.
Flexible, Simplified Claims
Automate and streamline the entire claims process, including eligibility checks, benefit applicability, claims summary, and post-submission claim form editing for a wide range of insurance products such as dental, life, vision, accident, long-term care, disability, critical illness, hospitalization, and more. Benefit from a flexible, simplified, STP-first, and automated claims operating environment that offers extensive calculation and payout options for benefit amounts, payment schedules, adjustments, overpayments, delayed claim interest, and OFAC checks.
Leverage Advanced Claims Management
Utilize end-to-end claims management, from intake to settlement and payment. Manage appeals, reopen claims, hold/release claims, void claims, resubmit claims, and archive claims efficiently with single-point-of-change functionality. Access a comprehensive 360-degree dashboard for each claim, allowing a unique cross-LOB claim view, effective discrepancy management to align claim data with policy, and an event center to monitor claims timelines and action plans.
Deliver Exceptional Customer Experiences
Provide customers with end-to-end, digitally enabled claims handling that meets their expectations and future demands. Enable case-driven straight-through processing, exception workflow, and support for various engagement channels. Empower claims adjusters with a highly configurable and business rules-driven platform to meet the demanding expectations of customers.
L&AH Core Suite Solutions
Exceptional Claims Management from Intake to Settlement
Deliver responsiveness, customer value, and business process improvements.
- Manage intake, settlement, payment, appeals, reopen, hold/release, void, resubmit, and archiving processes.
- Integrate systems to enhance the flow of information across departments.
- Store everything electronically on one central platform, eliminating paper files.
- Provide support for Short-Term Disability (STD), Long-Term Disability (LTD), Life (Whole, Term, and Universal), Accidental Death and Dismemberment (AD&D), Life Waiver of Premium Critical Illness, Hospital Indemnity, Accident, and Cancer.
Case-Driven Management with Straight Through Processing
Automate and streamline case management through always-on processing.
- Utilize a flexible, simplified, STP-first, and automated claims operating environment.
- Automate and streamline claims from eligibility check, benefit applicability, and claims summary to post-submission.
- Configure workflows and tasks to ensure your team focuses on complex decision-making rather than manual administrative duties.
- Gain better insights to make data-driven decisions.
Case-Driven Management with Straight Through Processing
Automate and streamline case management through always-on processing.
- Utilize a flexible, simplified, STP-first, and automated claims operating environment.
- Automate and streamline claims from eligibility check, benefit applicability, and claims summary to post-submission.
- Configure workflows and tasks to ensure your team focuses on complex decision-making rather than manual administrative duties.
- Gain better insights to make data-driven decisions.
Better Claims Outcomes
Utilize built-in, rules-based best practices, workflows, and third-party integrations.
- Assign the right claims to the right people at the right time to improve claim outcomes.
- Improve the accuracy and timeliness of claim decisions.
- Manage discrepancies, monitor timelines, and create action plans.
- Monitor claims timelines and action plans through the event center.
Featured Resources
Blog
Life Insurance Modernization with Digital Solutions
This is the fourth blog in a series on our Fall ’22 Release. Over the next few months, we will continue to spotlight how Majesco is helping insurers achieve relentless innovation and meet the ever-changing market needs with an outside in approach. Today’s customers expect the same seamless, personalized digital experiences around insurance that they…
Blog
Building Customer Relationships in L&AH Insurance with Data & Analytics
Some history in life insurance for you. A life insurance product that sold in 1982 had a “new” discounted premium for non-smokers. This was revolutionary — tying a personal behavior to underwriting a life policy premium. Oh, how we have advanced since then! What’s possible now goes so far beyond that, yet the idea is…
FAQ
Claims management software facilitates and automates the processing of claims for insurance companies. This process begins at First Notice of Loss (FNOL) and continues until final adjudication. This is where a claim is paid or in some cases denied. Claims management software is designed to streamline each of an insurance company’s internal processes within this workflow, allowing staff to be more productive while making better claims determinations.
Cloud solutions allow carriers to access their data and solution from anywhere at any time. In addition, Cloud solutions help to automate manual processes, help businesses keep up with technological changes, and simplify disaster recovery.
For a solution to be considered comprehensive it should at a minimum have features for document management, process/workflow automation, and claims settlement. Top-tier providers include additional features that further improve the user experience and productivity.
